Kenya faces worst epidemic in 10 years

Kenya is facing its worst cholera outbreak in a decade, and the situation can only worsen; the end of the short rains could push water scarcity deep into next year.

While cholera was first reported in Kisumu last December, of the 230 deaths reported across the country so far, almost half of them (119) have occurred in the last one month, which coincided with the onset of the short rains.

While forecasting these rains in October, the Metrological Department warned of the possible escalation of cholera and waterborne disease and advocated for sustained water chlorination campaigns.

Poor hygiene

Slums in Nairobi and semi-arid areas have been the hardest hit in the current epidemic which has been attributed to the consumption of street food, poor toilet coverage, unsafe drinking water and poor hygiene.

The outbreak in Kenya since documentation with the World Health Organisation started in 1971 was from 1997 to 1999 where 33,400 cases were reported, with an estimated 500 deaths.

According to the Ministry of Public Health and Sanitation, some 10,940 cases have been reported from the current outbreak, indicating a higher intensity of spread than in the previous outbreak.

Within only one year, since last December, reported cholera cases and deaths are almost halfway what the disease had attained within three years in the 1997 outbreak. This severity has been attributed to higher population density and overcrowding in slums.

According to Nairobi Water company spokesman Mbaruku Vyakweli the city population has outgrown the current installed water holding capacity hence shortages even during good rains.

“Water rationing will continue,” Mr Vyakweli told the Nation on Monday. He said water from their network was wholesome with enough chlorine to kill any pathogen including that causing cholera.

However, the majority of people in Nairobi and those in slums are not connected to any mains and depend on water hawkers, some vending unsafe water. Even those connected will have to depend on hawkers during water rationing.

Although the rains in some parts have been good, he said much more was required to raise water levels at Ndakaini Dam, the major supplier to the city.

“We have only achieved 57 per cent capacity,” he said.

The onset of the short rains was expected to ease pressure on the few water points, which were highly polluted during the long drought period in North Eastern districts.

But in some parts, the rains have been intermittent, with barely any consequence. The most recent forecast indicates the expected El Niño rains, which could have gone a long way towards replenishing water reservoirs, may not be coming after all.

The forecast indicates the short rains will cease within the next three to four weeks in many parts of the country including the whole of North Eastern, Eastern and the Coast.

However western Kenya Nairobi and central Kenya may continue to receive rains right into January — which will be moderate to mild.

The end of the rains at the current levels will mean continued use of unclean water in slums and extensive pressure on water points in arid areas.

The chief executive officer at Kenyatta National Hospital Jotham Micheni says what the country is facing could be a full scale cholera outbreak and should be treated as a national emergency.

Dr Micheni, whose hospital is treating five cholera patients daily from city slums, describes this as a silent epidemic, which requires urgent intervention by the public, the government and the private sector.

To change the tide, minister Beth Mugo wants Sh500 million in emergency funding to cope with the disease, the bulk of which is expected to go to water chlorination as a short term measure.

Medical experts are asking the government to weigh the possibility of introducing cholera vaccine to vulnerable groups. Such groups, say Dr Nicholas Ochieng’ of KNH, could include food handlers.

Dr Charles Chunge, a medical consultant and specialist on travel medicine says the cost of the vaccine that’s already in the country could be steep at about Sh3,000 for two doses, but if the government bought in bulk the prices could go down.